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CSUS Speech-Language Pathology > Medical SLP - Exam 2 > Flashcards

Medical SLP - Exam 2 Flashcards

1
Q

Endoscopic Results (5)

A
  • normal speech
  • consistent VPD
  • task-specific VPD
  • Irregular VPD
  • Abnormal resonance without VPD
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2
Q

What are endoscopic evaluations looking for?

A

Whether surgery is an option or not, what kind of surgery, and prognosis for success.

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3
Q

Management options for VPI/VPD

A
  • Pharyngoplasty (augmentation, sphincter and flap)
  • Speech appliance (retainers, obturators and lifts)
  • Behavioral Management (surgery)
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4
Q

Pharyngeal Flaps

A

Inferior and Superior: can cause sleep apnea. not a great method.

Midline and Lateral (circular - cuts palatopharyngeus)

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5
Q

Sphincter Pharyngoplasty

A

cuts palatopharyngeus

  • doesn’t always get complete closure.
  • may not be effective as a flap
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6
Q

Pharyngoplasty

A

surgery on the velopharynx

might complicate a class III malocclusion

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7
Q

Pharyngoplasty Augmentation

A

think boobjob

-take some material (saline/silicon wrapped in dacron ike a pillow), suture it to the posterior pharyngeal wall which makes the posterior wall closer to the velum. good for platybasia.

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8
Q

Speech appliances are made by a..

A

Prosthodontist

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9
Q

Speech appliances

A

Advantages: no risk, can be easily changed and used their whole life.
Earlier management is possible, revisions can be done when necessary, may stimulate growth

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10
Q

Types of Appliances

A

Palate Obturator - anchor with teeth.
Palatal Lift - regular retainer with tail to lift velum closer to pharyngeal wall.
Obturator with a Speech Bulb - tail with bulb plugs hole

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11
Q

Circumstances for Favoring a Speech Appliance

A
  • younger children (3-5 years)
  • unknown etiology
  • severe paralysis
  • severe articulation disorder/delay
  • mild resonance imbalance
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12
Q

VPI/D hearing issues and effect on language

A
  • language delay
  • conductive hearing loss
  • middle ear disease (MED)
  • hearing acuity
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13
Q

Obligatory Errors

A

physically unable to make the sound; consistent with errors; surgical fix only.

  • correct place but not voice or manner
  • nasal air emission (NAE)
  • hypernasality (voice error)
  • air escaping in odd places because of dentition
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14
Q

Compensatory Errors

A

most common; trying to make themselves intelligible; mostly substitutions; mostly place rather than manner changes.

  • incorrect place, voice or manner
  • nasal & pharyngeal fricative
  • glottal stopping
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15
Q

Nasometer

A

objective computer assistive instrument that measures how much air is coming out of the nose and mouth

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16
Q

Surgical Lip Repair: first thing needed

A

connect the orbicularis oris

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17
Q

Rule of 10’s for Lip Repair

A

baby needs to be 10lbs, have a minimum of 10 grams of hemoglobin (O2) in the blood for anesthesia, and 10 weeks of age.

otherwise surgery have the potential to suffocate the child.

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18
Q

Straight Line Lip Repair

A

cut and sew the edges together. tight repair and tension of the epidermis can stop jaw from growing forward. can cause notching of upper lip.

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19
Q

Triangular Flap Repair (Tennison-Randall)

A

triangle shaped tissue block is removed from the lip. lengthens lip; nice vermillion repair. bilateral and unilateral.

if you cut tissue off the lip your repair potentially needs to be too tight to get it to close.

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20
Q

Millard Rotation-advancement technique

A

cut triangle at the top, release it, pull it down, fit into lower notch on either side. lengthens lip and sews together without cutting out any tissue. bilateral and unilateral.

21
Q

Palate repairs are…

A

soft tissue repairs. the only bone used is for the alveolar ridge.

22
Q

Types of One-Stage Palate Repairs

A
  • free-flap
  • Furlow Z-Plasty for the soft palate
  • Von Langenbeck
  • V-Y Retroposition procedure (Wardill Pushback)
  • Vomer Flap
23
Q

Free Flap Repair

A

take a flap of skin from somewhere else and put it in the palate (e.g., crook of the elbow or back of knee)

24
Q

Furlow Z-Plasty for the soft palate

A

superior epithelium is raised in a couple of flaps as well as the inferior. flaps are sewn in the shapeof a Z in opposite directions.

Lengthens the soft palate.

25
Q

Von Langenbeck

A

hard and soft palate, not including alveolus

cuts flaps off of the palatal shelves and sews everything together at midline. gaps left fill in. when surgeon lifts flap, need to be careful not to denude the bone.

26
Q

V-Y Retroposition Procedure (Wardill Pushnack)

A

tissue is not cut off. slices are made and tissue is lifted off the bone. hard and soft palate.

27
Q

Vomer Flap

A

taking tissue off palatal shelves and off the septum

28
Q

Two-Stage Palate Repair

A

do not support!

  • done around 12 and then 24 months
  • fistulae tend to develop
29
Q

Fistulae

A

an opening that comes up before the surgical site has healed; almost impossible to repair.

-functional if it has an effect on speech, eating or drinking.

30
Q

Orthognathic Surgery

A

bone graft to the alveolus.

done when there’s a cleft in the alveolus, timing is controversial. generally, attempts are made to close fistulae at this time.

31
Q

Maxillary Osteotomy

A

surgical repairs probably disrupt blood supply, nerve supply and growth.

-Le Fort Procedures which potentially pull velum causing VPI

32
Q

Le Fort I & II both start by…

A

peeling skin away from bone without cutting. drill holes in the maxilla and then cut by connecting the dots. this moves the maxilla forward. prevents dental occlusion. dog bones (titanium) go across gap and are screwed in. t

aesthetics and occurs when facial growth is finished in teenagers.

33
Q

Le Fort I

A

moving the dental arch. cuts maxilla at dental arch. orofacial maxillary surgeon. no zygomatic is cut. muscles change.

34
Q

Le Fort II

A

pulls off more skin (cut cartilage on nose). pulls more maxilla forward up to beidge of nose. more facial skeleton and orbit of the eye. orofacial maxillary surgeon. no zygomatic is cut.

35
Q

Le Fort III

A

cranial surgeon because brain is exposed. cut is made around hairline, skin peeled down to lay over chin. orbits of the eye and part of frontal and nasal bone is pulled forward. held by dog bones or potentially bone grafts. zygomatic arch IS cut.

36
Q

maxillary advancement can create….

A

velopharyngeal dysfunction

37
Q

Mandibular Osteomy

A

shortening of the mandible. cut jagged line in the mandible, then either take out chunk and slide pieces together to shorten mandible or do distraction osteogenesis (for Pierre Robin).

38
Q

Deciduous Teeth

A

Baby Teeth
A-J are on the maxille R to L
K-T are on the mandible L to R
no bicuspids or 2nd and 3rd molars

39
Q

Permanent Teeth

A

adult teeth
1-16 on the maxilla R to L
17 is under 16, 17-32 on mandible L to R

wisdom teeth = 3rd molars

40
Q

SLP evaluation of speech and language before physical management

A

Language assessment
FNAE/Hypernasality
developmental errors and Phonological processes
Endoscopic evaluation
work with family and inform them (praise place even if manner is incorrect)

41
Q

Role of the SLP after physical management

A

training the patient to make the best of the appliance or pharyngoplasty, reduce NAE/hypernasality, eliminate articulation errors, assume the surgery or obturator was a good fit.

42
Q

Speech Therapy Goals

A

1) Decrease VP patency
2) Decrease NAE/increase oral pressure - octopus, cul-de-sac technique
3) Decrease Hypernasality
4) Decrease Compensatory Errors

43
Q

The velum is ________, lacking _____________ which tell the velum it’s position in space

A

asensory

proprioceptors

44
Q

Non-speech activities and the closure they produce _______ carry over into speech activities because they’re ______________ _________.

A

don’t

neurologically different

45
Q

the _____ culture considered clefting to be a sign of blessing from the Gods

A

Mayans

46
Q

The primary plates form between __ to __ weeks of gestation and the secondary plates form between __ to __ weeks of gestation

A

6 to 8

8 to 10

47
Q

contour of the face is generally complete around the __th week of gestation

A

14

48
Q

____________ ultrasound gives clearer picture

A

transvaginal

CSUS Speech-Language Pathology (23 decks)

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